Born into so much hope, South Sudan's first baby “Independence Moses” shows nation has a long way to improve child survival

By: Hannah McNeish

JUBA, 9 July 2013 - As the countdown clock struck midnight on July 9, 2011, the streets of Juba pulsed with the throng of revelers crying out in joy at the birth of a new nation. But just meters away in the capital’s hospital, another cry went out as the world’s newest nation registered its first baby.

Born in a time of so much hope, in a place that had struggled for decades for freedom, parents Moses Nono and Josephine - both ripped from childhood and recruited into the army during the civil war - named the boy Independence Moses.

“Independence. We struggled for it for so long, and to have him in my house I just thought it was amazing,” says Moses.

Delivered safely at hospital, immunized and cherished as a national symbol of new beginnings, the baby had the best start in life in a country that was finally free but had little to boast about.

Quality Health services in the nation a major challenge

But seven months later, baby Independence got sick.

“It was just a case of malaria, just fever, then we took him to the clinic,” says Moses.

After a week of prescribed medicine couldn’t quell his rising temperature, they took him to another private clinic, spending what they had to get this special baby the best.

“We asked them to check for typhoid and other things. But with the medics here in Juba, they have little capacity and equipment,” Moses says of a country that is thought to have the lowest capacity in Africa, and where trained health professionals are scarily scarce.

“The medical system in South Sudan here is very poor. Juba here only has one big hospital and oversubscribed for the swelling population, he says.

“In South Sudan we have limited skilled health professionals,” says Nurse Susan Angel. She is one of 30 students at a Nursing and Midwifery college in Juba hospital which UNICEF supported with educational materials, where four of the country’s 12 registered midwives work.

Independence Moses no more

After a week of sickness and two clinics later, Independent went back to Juba hospital, where doctors struggled to even find a vein to hook his tiny frame up to a drip.

Just after midnight, a little life was lost, and with him went the family’s dreams of a brighter future that at independence had seemed so real.

“I was so very happy. I even took the flag and put it on my house to show the neighbors,” says Moses of the day they brought Independence Moses to his home on the outskirts of the capital.

“But God just took it down, and all that happiness went,” he says.

“I thought this baby would be so happy about his name when he grew up, and the country would be so happy too, and that he would maybe one day make a news story or be someone famous, someone better than me,” says Moses, who supplements his meager wage with odd jobs and working as a mechanic or the family only has enough for food.

Josephine and Moses hope that their other three children, named after American presidents Obama, Kennedy and Jimmy, will prosper, “but the problem is poverty.”

“I don’t care about myself but I need help with these kids. I need these kids to get an education so that they can improve life, to not be like me,” he says.

UNICEF supports health services

Despite improvements in South Sudan since the end of the civil war in 2005, one in nine children dies before turning five, and one in seven makes it to adulthood.

Disease is still the biggest killer, and UNICEF and partners are supporting a nationwide immunization campaign and cold-chain management to try and save children from six communicable diseases.

UNICEF Health specialist Martha Cayad-an says the organization is also working with the government and partners on plans for mother and child health programs across some 80 counties in South Sudan.

“If you really build the system at the county level, it’s the real backbone of the health system,” she says.

“Recently there are changes but there’s need for more training, especially in the labour ward,” says Nurse Angel.

“The package of UNICEF-supported maternal, neo natal and infant healthcare is already being rolled out in five counties, but limited infrastructure means access is still the biggest challenge”, Martha says.

The country has a dearth of roads and two thirds of it is cut off during rainy seasons, while over 80 percent of the population live in remote rural areas.

If there are clinics, “They very few are underequipped and most are not fully staffed,” says Angel.

Even at the nation’s leading hospital in Juba, there aren’t enough staff to fill the old building that patients lie outside on their own mats, swatting away the clouds of flies.

“They need to train more and more medical people as we are poor, and we need so much help,” says Moses, who prays for his remaining children not to get sick in the capital, that still largely relies on dirty water drawn straight from the Nile.

There is hope that organisations such as UNICEF and other donor-supported projects like the College of Nursing and Midwifery at the hospital will improve child and maternal mortality rates.

On the brighter side, increase in more qualified health personnel

Susan Angel, 34, says that she came back from Uganda to help her country when she heard that so many mothers and babies were dying during delivery, with 16 women dying every day due to pregnancy related complications.

She is one of 30 students graduating next month that are determined to raise the standard of care starting from the basics to identifying complications during pregnancy and birth and child sickness early.

“Compared to 2011, it’s a bit different now,” as nurses have been trained in infection control such as cleaning the ward and carrying out proper sterile procedures, says Angel.

“I’m very happy. This course has changed my life. Before, when I was in the nursing department, I didn’t know anything about women, about babies…but now I know all the complications and I can manage without anyone,” she says.

“What we are taught now is the backbone for human life…and my pride, when I see someone alive, I can see that it’s working,” says Angel, who hopes to continue studying as a midwife to be able to perform cesarean sections and save more lives.

But for the Nono family, help came too late, and remembering South Sudan’s birth will always be bittersweet.

“I feel so much pain about this baby, up to now. I will celebrate independence with my family at home…but I won’t go to the party.”

This sad story of Independence Moses is a clear testament to step up efforts from the government and all stakeholders to ensure improved child survival and development for all children of the new nation.